Scarey truth about old age and medical care...short BUT Yikes!

Discussion in 'The Watercooler' started by DDD, Dec 1, 2012.

  1. DDD

    DDD Well-Known Member

    My husband has had a clogged ear which turned into a problem today...on a weekend. I encouraged him to go to the ER because it seemed prudent (no reason to bore you guys with details) and he did so...much to my surprise. The bottom line is that after being treated by the MD in the ER he was given three Rx's. One was an Rx for an anticiotic liquid ointment for his ear. Ready, guys??? He went to a chain pharmacy because our usual pharmacy closes at noon on Saturday. That ONE Rx. cost almost $230 out of pocket and we have outstanding supplemental insurance with our Medicare. How scarey is that? Sadly we have to watch our expenses but with-o a little cushion he could easily have ended up with a mega infection and who knows what long term effects. My heart breaks for the ?# of people who are less fortunate than are. It's scarey. If I had been the patient I would have had them call the MD to see which otic product was similar and approved but husband is not like that. Good Grief! I still can't believe it. Whine. DDD
  2. DammitJanet

    DammitJanet Well-Known Member Staff Member

    DDD, This is one of the reasons I am so very happy that my monetary amount of SSDI falls exactly where it does. I get just a little more than the amount of SSI but I still make less than the cut off amount for medicaid which means medicaid covers all my copays that pay for the Part B, the 20%, I dont need a medicare advantage program, and I dont have to pay the cost of my Part D or worry about the donut hole.

    I couldnt afford all that stuff on even a few more bucks than I make. The first 200 and 20% would kill me alone. Not to mention I would hit the donut hole by about April.

    I really am worried about what is coming down the pike and keep waiting to see. Every time I hear "cuts to Medicare/Medicaid" I cringe.
  3. susiestar

    susiestar Roll With It

    I am glad that he was able to afford the medications that the doctor prescribed. A few days back Nancy posted about being surprised by the cost of xrays and how we need to be informed consumers. I think that this is esp true for the elderly. People now are more likely to question a doctor than they used to be. I wish that part of getting medicare/medicaid was a class in how to be an informed medical consumer. Not just to save money for medicare/medicaid, but to make sure people know to ask questions and insist on answers. My husband is HORRIBLE with this. He iwll NOT tell a doctor all that is wrong and will NOT admit he feels bad unless he is bad enough to truly NEED hospitalization. If I cannot go to the dr with him, I write a letter and the few times he didn't give the doctor the letter he had to make another ASAP appointment because I had a fit. Mostly because he was ignoring serious issues, but partly because he thought the doctor would somehow 'just know' by looking at him that some part was hurting - without him ever saying a word!

    I wonder what would the ER doctor have prescribed if husband had asked about the cost and if there was an older/cheaper medication that would work as well?? LOTS of docs get free food, office supplies, medical supplies like soap, hand sanitizer, tissues and even equipment like stethoscopes, pulse oximeters, etc.... from drug co reps. Then the docs rx the medications the rep talked about, partly because they feel they 'owe' the rep, and partly because that medication is in their mind when they see a patient. Drug reps are trained to make docs think of them and their products and their freebies and they are amazingly good at it.

    MOST of the time there is a cheaper, older medication that will work quite well. Not always, but mostly. Drug reps are trained to get docs to think their products are the only ones that will work, that they will work much, much faster and better with fewer side effects. SPECIFICALLY trained. I know quite a few people who were/are pharm reps and they are literally snake oil salesmen, in my opinion. Heck, the ones I know actually call themselves that -and they are PROUD of it. They usually know the 'improvement' usually isn't enough to justify the exorbitant prices, but that is not their problem. Listening to some of them talk at a reunion a few yrs ago was pretty scary as a consumer of medical care and medications.

    I am NOT saying your husband did anything wrong. He might well have needed that specific medicine. I have no idea, and he probably doesn't either. I would be surprised if the doctor did unless they cultured the bacteria, which takes a few days. I was shocked when I learned that. IT was when I had cellulitis and spent seven or eight days in the hospital. They truly were afraid they would have to amputate my leg when I went in. I was BLESSED in that I didn't push to go home on iv medications so they took the time to culture the bacteria. The culture showed that while it was a strain of necrotizing fascitis (flesh eating bacteria) and another type of bacteria that was equally bad but has a name I don't remember, but they responded to one newer antibiotic and one very old one. If I had insisted on going home while I needed the IV antibiotics, they would not have cultured it, but they would have put me on two very different antibiotics and it would not have responded well, if at all. The 3 days to culture made a HUGE difference in the cost of the medications I had in and out of the hospital. I also asked at almost every turn if there was a cost effective alternative.

    Have you ever asked the doctor if there is a cheaper, generic medcation? I know that many people in my parents and gparents generations did NOT ask the doctor questions about the treatment. I have had several older docs who hated that I questioned everything and did my own research on my health issues and medications. BUT this has saved my life several times because I avoided some problems and got treatment that I could actually afford rather than getting the rx's and going home and not fillign them because they were too expensive. If the doctor has a good reason for a newer drug, I am all for it. But if the only reason is that it is the medication they were thinking of, esp knowing what I do about drug reps, was not generic or inexpensive enough for me to afford it? Well, I think that is a HUGE problem. I think that our docs need to be more cognizant of the costs, and that we need to put as much informed consumer knowledge and questions into our medical care as we do into our organic veggies or our choice of car or any other purchase.

    Around here ALL the docs know what is on the $4 ro $3 (one local pharmacy has taken the Walmart list and made it $3 for a month) medication list and if you ask they will rx medications from that if possible. But like many docs, they get substantial incentives from drug co reps and they are human and want to reciprocate by rx'ing those medications that are being pushed.

    I just wish there was more we could do to help everyone become an informed consumer of health care just like we do cars and computers and tvs and organic whatevers.
  4. DDD

    DDD Well-Known Member

    You are right as rain, Suziestar. I'm assertive and he is not. I also think that he has the macho gene that means he doesn't want anyone to know that our finances are so "iffy".

    NOW...are you all ready for this??????? I'm not! Tonight he went to put his ear drops in his ear. NO he didn't need any help. OMG! The bottle slipped out of his hand and 98% of the drops flowed onto his shirt. I wish I were telling a hate joke but, alas, I'm not. He felt like a fool and was really angry. I insisted that there were probably some drops left and I did manage to get three in his ear. I think I can get three more in tomorrow morning. THEN WW3 will ensue because I'm insisting that he go to the specialist that I suggested last week and start all over again. I have HAD IT. All this blankin' stress is detrimental to my health and I'm through being sensitive and caring. WHOA! Be glad that you all aren't living in this home. Enough is enough. DDD (who truthfully does NOT like confrontation)
  5. PatriotsGirl

    PatriotsGirl Guest

    I recently had to get antibiotics for h pylori and it costed almost 200 dollars. I was shocked!!!! And I have insurance! Yes, our healthcare system needs a MAJOR overhaul....
  6. Fran

    Fran Former desparate mom

    DDD, my mom hit the "donut hole" about sept. for the last 3 yrs of her life. The first time I was stupidly unprepared having never heard of it. 830.00!!!!! She would have gone without if I hadn't stepped in. No way would she been able to pay that amount. Heck, I couldn't pay that amount. I did in the end get her signed up for some supplemental help via the proceeds from the lottery. If someone hadn't helped my mom to navigate the senior system of health care, she would not have taken her medications and she wouldn't have had the quality of her life.